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What is periodontal disease?

The term periodontal means “around the tooth.” Periodontal disease, more commonly known as gum disease, is a serious inflammatory condition that impacts the teeth’s supporting tissues, namely the soft tissues (gum), and eventually the jawbone in the disease’s most advanced stages.  The symptoms include bad breath, red and swollen gums, tender or bleeding gums, painful chewing, loose and sensitive teeth, and receding gums. 

Periodontal disease is caused by bacteria in dental plaque, a sticky film that forms on the teeth. If plaque is not removed, it organizes into calculus (tartar). The bacteria in plaque and calculus produce toxins that irritate and inflame the gums, leading to infection and damage of the tissues and bone that support the teeth. Periodontal disease is a progressive condition that eventually leads to the destruction of the gum tissue and jawbone.  If left untreated, it can cause shifting teeth, loose teeth, and eventually tooth loss. Poor oral hygiene, smoking, diabetes, and genetic factors can increase the risk of periodontal disease

Dental plaque

Periodontal disease affects 20% to 50% of the population worldwide. In the U.S., almost half of the adults aged 30 or older suffer from some type of this disease. Most people are not aware they have it because periodontal disease is usually painless in the early stages. Periodontal disease is the main cause of tooth loss. Research also indicates that periodontal disease may also be connected to other diseases like stroke, respiratory disease such as bacterial pneumonia, diabetes, cardiovascular disease, cancer, diabetes, Alzheimer’s Disease and pregnancy complications.

body impacts of oral bacteria into bloodstream

Understanding the stages, causes, and potential complications of periodontal disease is crucial for maintaining optimal oral health.


Stages of Periodontal Disease:

  1. Gingivitis:

    • Gingivitis is the initial stage of periodontal disease. It is characterized by inflammation of the gums caused by the accumulation of dental plaque—a biofilm of bacteria, saliva, and food particles. Common symptoms include red, swollen gums that may bleed during brushing or flossing. Gingivitis is generally reversible with proper oral hygiene and professional dental cleanings.

  2. Periodontitis:

    • If gingivitis is left untreated, it can progress to periodontitis, a more severe stage of gum disease. In periodontitis, the inflammation extends below the gumline, causing pockets to form between the teeth and gums. Bacterial toxins and the body's immune response contribute to the breakdown of the supporting structures, leading to bone loss, gum recession, and potential tooth mobility.

Causes of Periodontal Disease:

  1. Poor Oral Hygiene:

    • Inadequate brushing and flossing allow plaque to accumulate on the teeth, fostering the growth of harmful bacteria. This is a primary cause of gingivitis.

  2. Tobacco Use:

    • Smoking and tobacco use are significant risk factors for periodontal disease. Tobacco compounds interfere with the healing of gum tissues, making individuals who smoke more susceptible to infections and delayed recovery.

  3. Genetic Predisposition:

    • Some individuals may be genetically predisposed to a higher risk of developing periodontal disease. Genetic factors can influence the immune response and the body's ability to combat bacterial infections.

  4. Poor Nutrition:

    • A diet lacking in essential nutrients can weaken the immune system and compromise the body's ability to resist and recover from infections, including those affecting the gums.

  5. Medical Conditions:

    • Systemic conditions such as diabetes and autoimmune disorders can contribute to an increased risk of periodontal disease. Medications that reduce saliva flow or cause gum overgrowth may also be factors.

  6. Hormonal Changes:

    • Hormonal fluctuations, such as those occurring during pregnancy, menstruation, and menopause, can affect the gums and increase susceptibility to gingivitis.


Complications and Consequences:

  1. Tooth Loss:

    • If periodontal disease progresses unchecked, it can lead to the destruction of the supporting bone structure, resulting in tooth mobility and eventual tooth loss.

  2. Systemic Health Implications:

    • Research suggests a link between periodontal disease and systemic conditions such as cardiovascular disease, diabetes, and respiratory issues. The chronic inflammation associated with gum disease may contribute to the development or exacerbation of these systemic health problems.

  3. Pregnancy Complications:

    • Pregnant women with untreated periodontal disease may be at a higher risk of complications such as preterm birth and low birth weight.

Prevention and Treatment:

  1. Effective Oral Hygiene:

    • Regular and thorough brushing, flossing, and the use of antimicrobial mouthwashes are crucial for preventing and managing periodontal disease.

  2. Professional Dental Care:

    • Regular dental check-ups and professional cleanings help detect and address periodontal issues early. Dental professionals can provide guidance on effective oral hygiene practices.

  3. Smoking Cessation:

    • Quitting smoking and tobacco use significantly reduces the risk of periodontal disease and supports overall oral health.

  4. Healthy Lifestyle:

    • Maintaining a balanced diet, managing stress, and addressing systemic health conditions contribute to gum health.

  5. Scaling and Root Planning:

    • In cases of gingivitis and mild to moderate periodontitis, scaling and root planning are non-surgical procedures that remove plaque and tartar, promoting healing of the gums.

  6. Surgical Interventions:

    • Advanced cases of periodontitis may require surgical interventions, such as flap surgery to reduce pocket depth or bone and tissue grafts to restore lost structures.

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